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European Spine Journal

, Volume 26, Issue 9, pp 2242–2257 | Cite as

National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy

  • Per Kjaer
  • Alice Kongsted
  • Jan Hartvigsen
  • Alexander Isenberg-Jørgensen
  • Berit Schiøttz-Christensen
  • Bolette Søborg
  • Charlotte Krog
  • Christian Martin Møller
  • Christine Marie Bækø Halling
  • Henrik Hein Lauridsen
  • Inge Ris Hansen
  • Jesper Nørregaard
  • Karsten Juhl Jørgensen
  • Lars Valentin Hansen
  • Marie Jakobsen
  • Martin Bach Jensen
  • Martin Melbye
  • Peter Duel
  • Steffan W. Christensen
  • Tina Myung Povlsen
Review

Abstract

Purpose

To summarise recommendations about 21 selected non-surgical interventions for recent onset (<12 weeks) non-specific neck pain (NP) and cervical radiculopathy (CR) based on two guidelines from the Danish Health Authority.

Methods

Two multidisciplinary working groups formulated recommendations based on the GRADE approach.

Results

Twelve recommendations were based on evidence and nine on consensus. Management should include information about prognosis, warning signs, and advise to remain active. For treatment, guidelines suggest different types of supervised exercise and manual therapy; combinations of exercise and manual therapy before medicine for NP; acupuncture for NP but not CR; traction for CR; and oral NSAID (oral or topical) and Tramadol after careful consideration for NP and CR.

Conclusion

Recommendations are based on low-quality evidence or on consensus, but are well aligned with recommendations from guidelines from North America. The working groups recommend intensifying research relating to all aspects of management of NP and CR.

Keywords

Clinical guideline Neck pain Cervical radiculopathy Non-surgical intervention Recommendations Conservative treatment 

Notes

Acknowledgements

The authors would like to acknowledge the following members of the project groups and working groups: Karsten Junker, chairman CR working group, research librarians Herdis Foverskov, Kirsten Birkefoss and Conni Skrubbeltrang; lead reviewer Frank Lønberg; members of the working groups Hans Kristian Lauritsen, Jørgen Korsgaard, Peter Kryger-Baggesen, and Anne Gram.

Compliance with ethical standards

Funding

Funding was provided by The Danish Finance Act in 2012, and the DHA was commissioned to formulate the national clinical guidelines based on this. A salary was provided to members of the project groups, i.e., lead reviewers (AK, PK, and FL), project managers (BH and CH), methodologists (KJJ, MJ, and TP), search specialists, and chairmen. The funders had no role in the design, collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for public No funding was provided to the working or reference group members.

Conflicts of interest

Potential conflicts of interest have been declared by all involved partners and made publicly available on the DHA webpage (in Danish) [18].

Supplementary material

586_2017_5121_MOESM1_ESM.pdf (1.3 mb)
Supplementary material 1 (PDF 1317 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Per Kjaer
    • 1
    • 2
  • Alice Kongsted
    • 1
    • 2
    • 3
  • Jan Hartvigsen
    • 1
    • 3
  • Alexander Isenberg-Jørgensen
    • 4
  • Berit Schiøttz-Christensen
    • 5
    • 6
  • Bolette Søborg
    • 2
  • Charlotte Krog
    • 7
  • Christian Martin Møller
    • 8
  • Christine Marie Bækø Halling
    • 2
    • 9
  • Henrik Hein Lauridsen
    • 1
  • Inge Ris Hansen
    • 1
  • Jesper Nørregaard
    • 10
  • Karsten Juhl Jørgensen
    • 2
    • 11
  • Lars Valentin Hansen
    • 12
  • Marie Jakobsen
    • 2
    • 9
  • Martin Bach Jensen
    • 13
  • Martin Melbye
    • 14
  • Peter Duel
    • 15
  • Steffan W. Christensen
    • 16
    • 17
  • Tina Myung Povlsen
    • 2
    • 18
  1. 1.Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdense MDenmark
  2. 2.Evidence, Education and Emergency ServicesThe Danish Health AuthorityCopenhagen SDenmark
  3. 3.Nordic Institute of Chiropractic and Clinical BiomechanicsUniversity of Southern DenmarkOdense MDenmark
  4. 4.Centre for Spine Surgery and Research, Spine Centre of Southern DenmarkHospital LillebaeltMiddelfartDenmark
  5. 5.Spine Centre of Southern DenmarkHospital LillebaeltMiddelfartDenmark
  6. 6.Institute of Regional Health ResearchUniversity of Southern DenmarkOdense MDenmark
  7. 7.Københavns Fysioterapi I/SKøbenhavn ØDenmark
  8. 8.CFR HospitalerHellerupDenmark
  9. 9.KORAthe Danish Institute for Local and Regional Government ResearchCopenhagen KDenmark
  10. 10.Centre for Rheumatology and Spine DiseasesHillerødDenmark
  11. 11.The Nordic Cochrane CentreRigshospitaletCopenhagen ØDenmark
  12. 12.Spine Unit, Department of Ortopaedic SurgeryRigshospitaletCopenhagenDenmark
  13. 13.Research Unit for General Practice in Aalborg, Department of Clinical MedicineAalborg UniversityAalborg ØDenmark
  14. 14.Aalborg Spine ClinicAalborg RygklinikAalborgDenmark
  15. 15.Neurosurgical DepartmentAarhus University HospitalAarhus CDenmark
  16. 16.Department of Health Science and TechnologySMI®, Aalborg UniversityAalborgDenmark
  17. 17.Department of PhysiotherapyUniversity College of Northern Denmark (UCN)AalborgDenmark
  18. 18.Research and Test Center for Health Technologies. RigshospitaletGlostrupDenmark

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